Community Health Planning and Policy Development
Section Newsletter
Fall 2003

Message from the Chair

There’s some kind of magic in the CHPPD air. Maybe it’s because our members are active in so many venues, maybe it’s because we attract activists. Whatever it is, CHPPD members seem to be everywhere in APHA and especially in leadership positions. Did you know that:


  • Both candidates for APHA President-elect, Suzanne Nichols and Walter Tsou are CHPPD members:

  • One of the candidates for the Executive Board -- Karen Valenzuela -- is a CHPPD member; and

  • The Chair of the Science Board -- Harry Perlstad -- is a CHPPD member.


We are approaching the time when everyone needs to make arrangements for the Annual Meeting. I’m pleased to point out that our Section is involved in 337 sessions -- more than 75 percent of the sections. It’s apparent that APHA is truly the premier forum for people interested in the issues the Section encompasses to present their work and ideas.

The rest of the newsletter is dedicated to activities that will happen at the Annual Meeting. I encourage anyone who has an interest in getting involved with our Section to attend our business meetings. It’s not too early as I have learned to start the process of finding people who are interested in serving in the section leadership. We will need leadership candidates for next year. Please see me, or any of our Section leadership members, during the meeting to let us know of your interest.

I look forward to seeing all of you in San Francisco.

Section News

MEMBERSHIP

Did you know that the Community Health Planning and Policy Development Section is the sixth largest section in APHA? As of June 1 we had 1,554 members, representing almost 6 percent of the membership, a 71 member gain over last year. These statistics reflect the importance and relevance of community health planning in the current environment.

Despite our size, we need each and every one of you. In order to be successful, we need people from all aspects of community health planning to participate in the work of the section. We need people who work in hospitals, in state and county health departments, in community based organizations, consultants, academicians, physicians, federal government workers. The essence of the section is participation.

If you will be in San Francisco, please join us for our meetings (the schedule is listed in this newsletter). Please be sure to join us for our social hour on Monday evening. If you will not be in San Francisco, we hope you will volunteer to participate in the work of the section, which takes place year round. We need members on the Awards Committee, the Program Committee, the Membership Committee and writers for the Newsletter. Please contact Pat McGeown, Membership Chair, at <pmcgeown@nycap.rr.com> about your interest. She will put you in touch with the appropriate committee chair.


PROPOSAL TO EXTEND TERMS OF SECTION CHAIR,
CHAIR-ELECT AND SECRETARY


CHPPD’s leadership council, which includes the current officers, governing councilors, and section councilors, is recommending that the Section Chair, Chair-Elect, and Secretary be elected for a two-year term. The officers of several other APHA sections serve for two-year terms and generally find that it works well. Current and past officers expressed the view that one-year terms are too short given the time it takes to learn the job and move section business forward. The recommendation is based on a survey of other APHA section election policies and report prepared by Tom Piper, Monica Chan and Toni Pickard. For a copy of the report contact Tom Piper at <macquest@mchsi.com>.

The CHPPD bylaws will need to be amended to implement this recommendation. This will be done through a two-step process. In the next few days, perhaps even before this newsletter is published, a blast e-mail from APHA will go out to all CHPPD members. This e-mail will inform members about the proposed bylaws change and request that they contact a Section Council member of their preference to vote. During the Annual Meeting a formal vote by Section Councilors on the bylaws change will be taken during our Business Meeting Sunday, Nov. 16, 6:00 p.m.-7:30 p.m. in the Marriott, Sierra K. Please feel free to attend and express your preferences at this meeting.

SECTION ELECTIONS TO BE HELD AT APHA ANNUAL MEETING

Section members attending the APHA Annual Meeting in San Francisco will be asked to elect three representatives to the Governing Council and three representatives to the Section Council. The process will be similar to that of the bylaws change. A blast e-mail with the candidates will go out and CHPPD members will be asked to contact a Section Councilor of their preference to transmit their votes. Again at the Annual Meeting, the Section Councilors will take a formal vote during our Business Meeting Sunday, Nov. 16, 6:00 p.m.-7:30 p.m. in the Marriott, Sierra K. A list of nominees and their statements is on the last page of this newsletter.

Current Section Councilors

Diane C. Albrecht, MS dianealbrecht@stny.rr.com

Harry Perlstadt, PhD, MPH perlstad@pilot.msu.edu

Carol B. Payne
carol_b.payne@hud.gov

Ruth (Toni) Pickard, PhD toni.pickard@wichita.edu

Marilyn Price, BA, MSW marilynlp@ispwest.com

Emylou A. Solomon esolomon@marchofdimes.com

San Francisco Here We Come ....

CHPPD has been the lead organizer of some 45 scientific sessions on topics related to community health planning and policy development, improving access for the underserved, addressing health disparities, and improving health outcomes. For the full program go to <www.apha.org/meetings>, or use the link at <http://www.ahpanet.org/CHPPD.html>, which also has additional information on places to stay.

And, don’t forget to come to our Business Meetings and Social Hour and to stop by our Booth in the Exhibition Hall.

SUNDAY, 11/16/03

10:00 a.m.-11:30 a.m. Membership Meeting (MCC, 307)

4:00 p.m.-5:30 p.m. New Members and Candidates (Marriott, Sierra K)

6:00 p.m.-7:30 p.m. Policy Discussion: a) Section b) APHA (Marriott, Sierra K)

MONDAY, 11/17/03

6:30 a.m.-8:00 a.m. Candidates II (Marriott, Sierra F)

6:30 p.m.-8:00 p.m. Social Hour (Marriott, Salon 2 - Yerba Buena Blrm)

Policy Perspective

POLICY PERSPECTIVE
By John Steen

(This article first appeared in the American Health Planning Association Newsletter, 2003, and is printed here with permission)

Whenever I’ve taught health policy analysis, I’ve begun with the ever-remarkable fact that our nation doesn’t have a national health care system, and that in place of one, we have fifty state “systems.” In addition not being systems, which would imply that they were designed to be what they are, they are constantly changing. With the lack of insight and will on the national scene producing a political impasse on the prospect of our establishing one, grassroots organizations, business and professional organizations and unions, and a few farsighted leaders have set in motion state initiatives for universal health insurance. Each and every one of them, most recently in Oregon and Massachusetts, has proven the impossibility of any state’s performing such a feat on its own. Even before most of these recent state initiatives, Cook County, Illinois (Chicago) sought to do so as a memorial to the late Cardinal Bernadin whose lifelong advocacy inspired it, with the same result.

All previous efforts notwithstanding, we should take a fresh look at California. That state secured a HRSA State Planning Grant to fund its Health Care Options Project, a conceptually more ambitious attempt to universalize health care. The resulting report presented last September contained nine separate proposals outlining how the state could get there. Three are single payer plans and have features of interest to health planners. All nine plans may be viewed by going to <http://www.healthcareoptions.ca.gov/doclib.asp>.

“CAL CARE” SINGLE PAYER PROPOSAL (Spelman and Health Care for All-California)
Among the progressive features in this plan are all the right incentives and none of the wrong ones – the moral antithesis of what we have now! There is a rich set of services including increased investment in health planning, prevention, and health education. That would translate into support for public health approaches to population health improvement, and public access to performance information. Regional boards of stakeholders, a health officer, and an office for consumer advocacy would be established in each county.
All this without any co-pays, too! This plan demonstrates the ability of single payer plans to realize cost savings through the reduction of administrative expenses. A Lewin Group analysis concluded that it could reduce insurer administrative costs by $6.6 billion, physician administrative costs by $5.2 billion, and hospital administrative costs by $2.3 billion. The total savings of $14.1 billion would be more than sufficient to fund the plan, and would even result in a net savings to the state of $3.7 billion in 2002.

CALIFORNIA HEALTH SERVICE PLAN (Shaffer)
Under this single payer plan, the state would be the sole employer as well as payer for the health care delivery system. State and local health departments would be funded for health planning, including the setting of quality targets and strategic planning to improve population health status. Health care workers and communities would be involved in planning and decision-making.

SINGLE PAYER HEALTH PROGRAM FOR CALIFORNIA (Kahn, Bodenheimer, Farey, Lingappa, and McCanne)
This plan is designed more from a physician perspective, and achieves single payer status with fewer alterations to the current landscape of service providers. It supports public health and prevention through earmarked funding, but it has some small co-pays (not for prevention). A uniquely progressive feature is its administration through not just an elected state health commissioner and a public state board, but also by regional boards that include providers, employers and consumers. In addition, there would be advisory groups for such issues as quality assurance, clinical guidelines and immigrant access.

It can surely be seen as ironic that so intelligent a set of public policy proposals are now being considered in the state least able to afford them by accepted ways of voter thinking, but that is the ace-in-the-hole for single payer plans that are self-financing. And anyway, we’ve long been saying that things would have to get a lot worse before they could get better, haven’t we? It has to be clearer in California than in any other state that they are on their own in dealing with their monumental state finance problems; no assistance can be expected from a hostile Bush Administration. It used to be said too that whatever was going to happen would happen first in California! We’ll see. The debate has been set. In February of this year, State Senator Sheila Kuehl introduced Senate Bill No. SB 921 patterned after these single payer proposals.

I DON'T GET IT!

by Tom Piper

Soaring health care costs are once again headline news:

- BIGGEST HIKE SINCE 1990
health care premiums for employer-sponsored plans hit 13.9% in 2003

- BABY BOOM GENERATION WILL BANKRUPT MEDICARE TRUST FUND
medical expenses from age 70 until death average $140,700 per person

- U.S. UNINSURE RATE ROSE TO 15.2% OF POPULATION IN 2002
up from 14.6% in 2001 totalling 43.6 million uninsured Americans

- HEALTHCARE COSTS SHIFTING TO GOVERNMENT
percentage of Americans who received health insurance through employers fell to 61.3 percent in 2002 from 62.6% in 2001, while government-sponsored insurance covered 25.7 percent of the U.S. population in 2002, up from 25.3 percent in 2001.

This is just a tip of the iceberg in trying to describe the growing crisis facing our country as a result of unchecked health care cost increases. Not only have dramatic increases in Medicaid and employee health insurance premiums helped bring state government budgets to their knees, but private business is reeling from health care costs that often far exceed the cost of materials for their products.

Policy-makers purport that health care providers must compete, but consumers don’t have the simpliest comparitive tools like price lists, quality indicators or payment choices. The purchaser of most health services is overwhelmingly the employer or government.

So, why are we allowing this to happen? I don’t get it . . . if this kind of escalation happened in food, or gasoline, or computers, or electricity, there would be a huge investigation, and we would have somebody’s head. We would scream: “I’m sick and tired of this, and I’m not going to take it anymore!”

We have the most advanced health care system in the world, pay the most money for health care of anyone in the world, and we rank less than 25th in health care status in the world. Where is the accountability, integrity and value in this situation, let alone “caring attitude” that we tell the world that we are known for?

I don’t get it . . .

Candidates for Section Office

Governing Councilor (Vote for 3)

CANDIDATE – Linda Slote Quick, BA, MSM
President, South Florida Hospital & Healthcare Association

E-mail: lquick@bellsouth.net

Bio: For thirty years, Linda Quick’s work has required familiarity with all aspects of South Florida’s health and human services systems. From neonatal intensive care to developments in hospice care, from hospital based psychiatric service to alternatives to hospitalization, the community-based health planning effort has required study and analysis of the full range and scope of health facilitates, sites, finances, and personnel. More importantly, her work on and with boards, committees and task forces has required interaction with the community’s and the country’s providers and consumers of health and social services. Quick maintains comfortable professional relationships with legislators, business leaders, physicians, nurses, social workers, journalists, educators, seniors, parents, and teenagers. Quick demonstrates strong skills in community organization arena as reflected by her status as a respected participant in many Florida, national and international human service forums. In her current position, President of the South Florida Hospital & Healthcare Association (SFHHA), she oversees activities working with over 50 institutional and 75 affiliate members in Broward, Dade, Monroe and Palm Beach counties, providing legislative representation at the local, state and national levels; educational programs for management and staff. Through leadership of The Healthcare Consortium she developed and directed several shared services and group purchasing initiatives for hospitals and physicians. As President of the SFHREF Quick raises funds to support an annual seminar on contemporary health care issues.

CANDIDATE – Peter D. Rizik:
Adjunct Associate Professor
Georgetown School of Medicine

E-mail: Rizikpeter@aol.com

Peter D. Rizik was appointed as an APHA Governing Councilor for the Community Health Planning and Policy Development Section. This is a position that opened up due to the resignation of Tony Schlaff. Rizik is currently an adjunct associate professor at the Georgetown University School of Medicine. He just completed a Legislative Fellowship with the U.S. Congress House Ways and Means Committee where he supported Medicare reform efforts. Rizik was President of the American Society for Microbiology's private corporation, a vice president at Science Applications International, and an analyst at IBM. After successfully completing a payback agreement as part of a DHHS NIMH service award, Rizik started his career as a health actuarial analyst and as a public health consultant to a Virginia County Public Health Department. Dr. Rizik received a doctorate from the Johns Hopkins University School of Hygiene and Public Health. Dr. Rizik has successfully completed executive education coursework at the Wharton School and the Harvard Business School. He received an AB from Carleton College. He has been an APHA member since 1983.

CANDIDATE – Mara H. Yerow, MPH, BS
Director, Massachusetts Medical Security Program
Massachusetts Division of Employment & Training

E-mail: myerow@detma.org

Mara H. Yerow is the Director of the Massachusetts Medical Security Program (MSP) for the Division of Employment and Training (MDET). She has been with the MDET for approximately four months and is the first full-time director of the MSP. Yerow has more than 20 years of experience in health administration, planning, marketing, government relations and policy development. Her previous positions have included Director of Planning and Policy Development for the Massachusetts Department of Mental Health; Hospital Vice President; and Executive Director of the Central Massachusetts Health Systems Agency (regional health planning agency). She has been active on health policy issues on both the state and federal levels. She serves on the Board of Directors of the American Health Planning Association and is a Governing Councilor of the American Public Health Association. She also serves on a number of regional, statewide and civic organizations. She is a graduate of the University of Pittsburgh Graduate School of Public Health with a Master’s in Health Administration. Her undergraduate degree is from the University of Massachusetts, Amherst. She is a Certified Healthcare Executive of the American College of Healthcare Executives.

Section Counselor (Vote for 2)

CANDIDATE – Ning Lu, Ph.D., MPH
Assistant Professor
Department of Public Health, College of Health and Human Services, Western Kentucky University

E-mail: ning.lu@wku.edu

Ning Lu graduated from the University of Pittsburgh with an MPH in Community Health and from the University of South Carolina with a PhD in Health Care Administration. Currently she is working as an assistant professor at Western Kentucky University. She teaches both undergraduate and graduate courses in public health and health care administration, conducts research and provides public services to the Central Kentucky region. Her research interests include social determinants of health, health behaviors, and health care for the underserved, children, women, and minority populations. She has been involved in many research projects and published several peer-reviewed journal articles relevant to community health planning and policy development. Lu has been a member of the Kentucky Public Health Association and APHA. Lu’s educational background and working experience have given her a great opportunity and equipped her to bridge the fields of public health and health care services.

CANDIDATE – Islara B. Souto, MPH
Manager, Cancer Information Service
University of Miami School of Medicine

E-mail: isouto@med.miami.edu; ibsouto@bellsouth.net

Islara B. Souto brings over 20 years of experience in public health. She has become nationally recognized for her work in community needs assessments and health planning, developing a model of collaboration that ensures participation and results. She serves on the Board of the American Health Planning Association, and has worked to develop an ePlanner Initiative for the use of marketers, planners, educators and administrators. As the Manager of a National Cancer Institute (NCI) program in cancer control, Souto helped to develop comprehensive cancer control programs in Florida, Puerto Rico and the U.S. Virgin Islands. Her background in cancer epidemiology has allowed her to provide over 1,500 national and local partners with analytical expertise and technical assistance. Souto is an expert in translating data into information that is useful in the design of evidence-based programs that meet the needs of patients, providers and the community. She has assisted community-based organizations, cancer centers and governmental agencies to position themselves competitively in cancer control services throughout the United States and the Caribbean. Souto has a Master’s Degree in Public Health, with an emphasis on health planning and administration, from the University of Tennessee, Knoxville. Her Bachelor’s degree is in Secondary Science Education. She studied medicine for four years, one in Mexico and three in Puerto Rico on a National Health Corp Scholarship; Souto left medical school when the NHCS program was severely cut in the early 1980’s. She has pursued a doctoral degree from Florida State University in medical geography.

CANDIDATE – Simbonika Spencer, BA, MPH
Volunteer Resources Director, Mid-Atlantic Division of the American Cancer Society (VA, MD, West VA, DE, and District of Columbia)

E-Mail: simbonika.spencer@cancer.org

Simbonika Spencer is a Public Health Professional currently employed by the American Cancer Society as the Volunteer Resources Director of the Society’s Mid-Atlantic Division. This includes managing volunteer recruitment, retention, and development and leading the Division’s Diversity Initiative. She has been involved in public health education and program development for over eight years. Prior to entering public health practice, she attained a Bachelor of Arts degree from the University of Virginia in Women’s Studies and Anthropology. After completing her undergraduate work, she attained a Master of Public Health degree from Medical College of Virginia/Virginia Commonwealth University. Professionally, she has worked in health law, managed care and general health education. Spencer continues to be actively involved in numerous local, state, and national health initiatives. She also writes periodically for several publications and speaks on various health topics throughout the state of Virginia.